Newly Launched ACC Public Reporting Program Includes PCI Metrics, But No Mortality…For Now
This week the American College of Cardiology (ACC) introduced its public reporting program with data on several measures related to PCI as well as implantable cardioverter defibrillator procedures. Patients and their families can easily search the online data, which come from hospitals participating in the National Cardiovascular Data Registry’s CathPCI and ICD registries.
“Public reporting is certainly not new,” said Gregory J. Dehmer, MD, of Baylor Scott & White Health (Temple, TX), in an interview with TCTMD. “There is an explosion of activity in public reporting right now … some of which is not bad and some of which, quite frankly, is not very good. The College felt pretty strongly that we had an obligation, since we have data that has been a source of valuable clinical information, to make it available to the public not only for the sake of transparency, but for the public to be able to use in making health care decisions.”
While the NCDR registries capture a number of important clinical metrics, only some of them were part of the initial public data release, which Dehmer described as “a very gentle and introductory approach.”
For PCI, data made public were:
- Proportion of patients with aspirin prescribed at discharge
- Proportion of patients with a P2Y12 inhibitor prescribed at discharge (patients with stents)
- Proportion of patients with a statin prescribed at discharge
- Composite: discharge medications (aspirin, p2y12 inhibitor, and statin) in eligible PCI patients
For ICDs, data made public were:
- ACE/ARB therapy at discharge for ICD implant patients with left ventricular systolic dysfunction (LVSD)
- Beta blocker at discharge for ICD implant patients with a previous MI
- Beta blocker at discharge for ICD implant patients with LVSD
- Composite: discharge medications (ACE/ARB and beta blockers) in eligible ICD patients
According to Dehmer, data will be updated each year and additional metrics will be reported from both registries, with an eye toward data releases from other registries as well. But the most controversial metric of all remains under wraps—at least for now.
“PCI mortality is an extremely sensitive issue right now in the interventional community and the College certainly recognizes that,” Dehmer said. The biggest concern regarding release of those data, he added, is how mortality data on high-risk subgroups such as out-of-hospital cardiac arrest patients and acute MI patients with cardiogenic shock should be reported in relation to PCI mortality in general.
It is an issue that will continue to be discussed and “hopefully they will come up with a way to report this,” he said, adding that a position paper from the American Heart Association recommends that out-of-hospital cardiac arrest patients, for example, should be tracked but not included in public reporting.
The publicly reported PCI
and ICD data can be found at FindYourHeartaHome.org.
American College of Cardiology. Hospitals nationwide begin reporting PCI and ICD measure results. http://www.acc.org/latest-in-cardiology/articles/2015/10/30/11/29/hospitals-nationwide-begin-reporting-pci-and-icd-measure-results. Accessed: November 5, 2015.
- Dehmer reports being the Chair of the ACC’s NCDR Public Reporting Advisory Group.
- Public Reporting of PCI Mortality Tied to Fewer High-Risk Cases But Better Outcomes
- Public Reporting Linked to Less PCI, Higher Mortality in Acute MI Patients
- Public Reporting of PCI Mortality May Have Unintended Consequences